Claims and Payments

The Founders and management team at ClaimLogic have been around long enough to see the complete evolution of the claim and payment transaction processing industry, also known as clearinghouses. ClaimLogic has evolved to become a national leader in the EDI claims and payment transaction processing market for providers of all shapes and sizes. In fact, on a national level our clients are submitting first time clean claim pass rates to payers of 99%, which results in faster payments and allows our clients to manage their operations with confidence. Through our experience and industry leadership, we understand the demands of delivering quality health care in this time of change and what it means to be proactive with our clients customization, client services and integration needs, and also the value of quality HIPAA controls that keep our clients focused on the business and quality billing side of healthcare.

Full Service Revenue Cycle Management

From all-payer primary and secondary claims through full payment processing, our clients benefit from the most robust and easy to use tools in the industry. Some features our clients benefit from are:

• All Payer primary and secondary Claims and ERA processing
• No claim transaction fees to PAR payers (see payer list)
• No transaction fee processing for ERA
• Real time or batch patient eligibility
• Industry leading data management/denial management and analysis 
• Payer, Provider and user analysis tools
• Medicare PQRI management and measurement tools
• Superior organization wide reporting, drilled down to the provider level 
• Unlimited users with defined staff access to work areas
• 1500 and 837 claim editors
• Automatic 835 to 837 tie back for easy viewing
• User level productivity monitoring tools
• Automatic archival for 7 years of all transactions with simple search access
• All HIPAA based transactions
• EOB Conversion tools to 835
• One click access to every payer form you currently use, appeal forms etc
• No set up, transition, training, enrollment, go live or support fees, period.. 

Around The Clock Real-Time Claims and Payment Processing

We also understand your need for real-time and immediate claims submission around the clock as well as immediate reporting on all accepted and rejected claim submissions, both on the front end and back end from the payers. All claims and payment data can be accessed with a simple click of the mouse in a very easy to use environment for all users. We pride ourselves in the most robust, yet easy to use claims and payment tools in the industry. Each user of the system has their own access areas for their claim files, as well as any super users who have access to all files. User access is defined and easily set up in the Administration area of the system, so that when they arrive for work, their work lists are ready to be worked. Here at ClaimLogic, you can submit claims around the clock, with no midnight holds placed on your claims and payments, so you are assured of immediate communication of reports to and from ClaimLogic and the respective payers. Please explore the many reasons why more and more providers are switching to ClaimLogic, improving productivity, increasing cash flow, decreasing denied claims and doing so in a more cost effective manner.